摘要
目的:观察等速肌力训练在不同介入时机和治疗时程对恢复期脑卒中偏瘫患者步行功能的影响。方法:选取恢复期脑卒中偏瘫患者63例,采用随机数字表法将其随机分为A组、B组和C组,每组21例患者。三组患者在常规康复治疗的基础上给予不同肌力训练,A组患者等速肌力训练4周后再进行抗阻肌力训练4周;B组患者抗阻肌力训练4周后再进行等速肌力训练4周;C组患者等速肌力训练8周。于治疗前、治疗4周和8周后采用等速肌力测试训练仪的峰力矩值(PT)、Berg平衡量表(BBS)、简化Fugl-Meyer运动功能量表(FMA)、功能性步行量表(FAC)和改良Barthel指数(MBI)分别评估三组患者的肌力、平衡功能、下肢运动功能、步行功能和日常生活活动(ADL)能力。结果:治疗4周后组内比较,三组患者PT、BBS、FMA、FAC和MBI评分较治疗前均显著改善,差异有显著性意义(P<0.05);组间比较,A组和C组各项评分均显著优于B组,差异有显著性意义(P<0.05),而A组与C组比较各项评分差异无显著性意义(P>0.05)。治疗8周后组内比较,三组患者各项评分较治疗前、治疗4周后均显著改善,差异有显著性意义(P<0.05);组间比较,A组和C组各项评分均显著优于B组,差异有显著性意义(P<0.05),而C组各项评分显著优于A组,差异有显著性意义(P<0.05)。结论:早期全程介入等速肌力训练可有效提高恢复期脑卒中偏瘫患者肌力和平衡功能,并显著改善其步行能力和ADL能力。
Objective:To observe the effect of different intervention time and training duration of isokinetic training on the walking function of patients with hemiplegia after stroke. Method:Sixty-three cases with hemiplegia after stroke were randomly divided into group A,group B and group C,21cases for each group.Patients in group A took isokinetic strength training in the first 4weeks, then took general resistant muscle strength training for 4weeks.Patients in group B were given general resis- tant muscle strength training at the first 4weeks,then given isokinetic strength training for 4weeks.Patients in group C were given isokinetic strength training for 8weeks.Peak Torque (PT),Berg Balance Scale (BBS), Fugl-Meyer Assessment (FMA),Functional Ambulation Category Scale (FAC)and Modified Barthel Index(MBI) were used to evaluate the balance function,lower limb motor function,walking function and ability of daily living of the patients in three groups before treatment,4weeks and 8weeks after treatment.Result:After 4weeks treatment,the PT,BBS,FMA,FAC and MBI scores of the three groups were signifi- cantly improved compared with those before treatment (P <0.05).The scores of group A and group C were sig- nificantly better than those of group B (P <0.05),but there was no significant difference between group A and group C(P >0.05).After 8weeks treatment,the scores of the three groups were significantly improved com- pared with those before 4weeks treatment (P <0.05),and the scores of group A and group C were significant- ly better than those of group B (P <0.05),and the scores of group C were significantly better than those of group A,the difference was statistically significant(P <0.05). Conclusion:Early and consistent intervention of isokinetic strength training could be more effective in improv- ing muscle strength,balance,walking function and ADL of the stroke patients with hemiplegia.
作者
段好阳
闫兆红
刘娜
刘福迁
怀志刚
李贞兰
DUAN Haoyang;YAN Zhaohong;LIU Na(Department of Rehabilitation in the First Hospital of Jilin University,Changchun,130021)
出处
《中国康复医学杂志》
CAS
CSCD
北大核心
2018年第10期1173-1177,共5页
Chinese Journal of Rehabilitation Medicine
关键词
脑卒中
等速肌力训练
恢复期
介入时机
疗程
步行功能
stroke
isokinetic strength training
intervention time
training duration
walking function
